When it comes to sleep, where we spend nearly one-third of our lives, many individuals in our culture are finding it more and more difficult to accrue the quality rest needed to support physical, emotional and psychological well-being. At this time, there are millions of people in the United States suffering from sleep problems and looking for solutions. “Sleep is a normal biological process that allows one to transition from a wakened state of consciousness to a state of consciousness that supports biological restoration, psychological restoration, health and well-being” says Larry Cammarata, Ph.D., a clinical psychologist who counsels individuals suffering from sleep problems and related emotional issues.
How can we reduce the suffering and anxiety that many people with sleep difficulties experience?
“An integrated approach utilizes treatments that are research-validated, as well as complementary and alternative methods to conventional medicine to find a solution,” he says.
Each person has a unique sleep remedy, or set of cognitive and behavioral resources that support a healthy wake-sleep cycle. In other words, one treatment does not fit all, says Cammarata. “Where we begin depends on the person and their unique beliefs, behaviors and ways of relating to sleep and/or to their sleep problems,” he says.
The integrated approach he uses includes mindfulness, behavioral and cognitive or psychological components. “I often see people who don’t want conventional methods of treatment” — these are people looking for an alternative to sleep medication as well as relief from distress, anxiety, or suffering, says Cammarata.
MINDFUL LIVING, MINDFUL SLEEPING
One of the keystones of Cammarata’s approach is mindfulness — not only mindfulness meditation, which has proven itself to be as effective as sleep medication in resolving sleep issues by researcher Dr. Jason Ong at Rush University, but also through “awakening awareness of what one is focusing on throughout the day.”
What we think about and what we do during the day is inevitably interconnected to the quality and quantity of our sleep, says Cammarata. “What we perceive, how we talk to ourselves, how we relate to sleep, these are all areas where we can cultivate mindfulness.”
As individuals practice mindfulness and grow their awareness into everyday living, they can increase their ability to make what Cammarata calls “pro-sleep choices.” Choosing to have more self-compassion and reducing the worry and general anxiety entangled in a sleep issue are examples of these, he notes. With time, Cammarata says, the mindfulness approach helps to train the body, mind and emotions to prevent and handle stress stimuli more easily.
This brings us to the behavioral component of sleep restoration and looking at “what behaviors a person has in relationship to sleep and night time in general,” says Cammarata. This can involve breaking a behavioral pattern, such as computer and television use, “clock watching”, late-night arguments and other activities that degrade a good night’s rest, he mentions.
In some cases, Cammarata notes, physically restricting the use of the bed “for sleep and love-making only” and reducing “sleep interfering arousal, such as light and noise” can be effective. Sleep even impacts our body’s ability to properly function. “Sleeping in a noisy environment has been shown to decrease immune system functioning, which is consistent with research findings correlating poor sleep with decreased immunity from illnesses,” he shares.
However, his most “secret peaceful weapons” to create healthy, normalized sleep-wake patterns are light and darkness. While he dislikes the idea of formulas, Cammarata says that “natural light during the daytime, complemented by sleeping in a completely blackened environment, will help support the natural melatonin production in the brain.”
It works like this: By exposing yourself to natural light in the morning, your body knows it’s time to decrease melatonin production, creating an alert and aware state in the brain. Your brain literally wakes-up. As the day passes and nighttime draws near, we need to lower our light consumption in order to encourage melatonin production, he explains. This increase in melatonin production brings about “the drowsy feeling” that precedes sleep.
Cammarata notes that people who proclaim how quickly they can fall asleep may in fact be sleep-deprived. “Ideally, you would go to sleep when you are drowsy, when the nodding and blinking starts to occur, rather than when you are fatigued.” Falling asleep within 20 minutes is no big deal, but less than one minute may indicate deprivation, likely caused by fatigue, Cammarata suggests.
When you push past the initial state of night-time drowsiness, “the natural internal neuro-biological and neuro-chemical limits are also being pushed,” says Cammarata. This has implications on the body systems that regulate our emotional, psychological and physical well-being.
A cultural affair?
As Cammarata puts it, many people in “our culture have sleep-deprivation and may not know it or admit it.” As we continue to push past our bodies’ natural regulatory rhythms, we can become “habituated to our sleep deprivation,” he says. Adapting may mean “drinking more coffee or no longer perceiving our level of fatigue, making it easy to deny that there is anything wrong with our sleep.”
We are caught up in what he calls “a hyper-aroused culture.”
While most clinicians are trained in the psychological or biological aspects of sleep problems, the impact of culture upon sleep is often not addressed. The amount of stimuli acting on the senses everyday combined with our own predilection for doing-ness not only stimulates the body, but also the brain, he explains.
“Sleep is a sacred state of consciousness,” says Cammarata.
Together with his wife Linda, Cammarata travels the world teaching mindfulness. “We see many different cultures and how differently they think about and relate to sleep.” He mentions that in the culture of countries like Bali, there is one day a year where everyone observes silence; it is a time when stopping and slowing down are revered.
To mitigate the over-stimulation of our minds and bodies and the implications this has on our ability to experience the “sacred state of consciousness,” Cammarata has developed what he calls “The 5 R’s of Self-Regulation” — Rooting, Relaxation, Respiration, Rhythm and Remembering.
“Rooting refers to being harmoniously connected to your body as well as sources of social and environmental support.” Rooting provides a degree of acceptance and stability to fully deal with a sleep problem as it truly exists in reality, Cammarata explains.
Relaxation allows for a release or letting go of tensions accumulated in the body and mind, he explains. “One relaxing self-suggestion that can support sleep is, ‘My body is heavy and relaxed’. Silently repeat this statement several times as you lie upon your bed, without trying to feel heavy or relaxed,” Cammarata suggests.
Respiration involves breathing in a manner that calms and regulates the nervous system. Rhythm, meanwhile, refers to “the slowing down of physiological processes prior to sleep.” Cammarata says that one rhythmic practice to prepare for sleep is to “speak slowly and softly, move slowly and breathe slowly, allowing this slow rhythm to follow you into the bed in preparation for sleep.”
After all, when have you ever heard of the admonition, “hurry up and get to sleep”?
Remembering means being mindful of all five principles throughout the day. “Mindfulness helps you to remember the intention, focus, practices, and attitudes that can support you in your journey into restful sleep.”
Ultimately, says Cammarata, it “is possible to solve sleep problems and decrease the suffering associated with impaired sleep.” He notes that the most important aspect of healing a sleep problem is “believing in your own ability to resolve the problem.”